United States' Lilly King, left, and Russia's Yulia Efimova competed side-by-side in the final of the women's 100-meter breaststroke Monday at the 2016 Summer Olympics in Rio de Janeiro, after King called out Efimova on doping.

Lee Jin-man/AP

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The World Anti-Doping Agency couldn’t stop Russian doping. The International Olympic Committee declined to ban Russia from the Rio Games. And so the global fight against doping in sports came down to a 19-year-old American in a bathing suit, Lilly King.

Her disparaging comments about Russian rival Yulia Efimova, who was twice suspended for doping violations, in some ways brought more attention to the issue than the proceedings of an alphabet soup of antidoping agencies.

The facts regarding Efimova's case are not black and white – at least, not based on what has come to light so far. But what is clear is that the fight to clean up sport has entered a new stage in which those most affected by cheating – the athletes themselves – are no longer willing to leave the field to the top officials in sport.

“You’re shaking your finger No. 1, and you’ve been caught for drug cheating. I’m just not a fan,” said King, after Efimova won her first semifinal heat. King beat her rival’s time in the second semifinal, then outswam Efimova in the final Monday night, capturing gold in her Olympic debut race, the 100-meter breaststroke. “It’s incredible, just winning a gold medal, and knowing I did it clean.”

King’s cri de coeur, amplified by the world’s largest sporting stage, reflects a cultural change that has opened the door for such frank discussion. Rather than being criticized, as US Olympic swimmer Shirley Babashoff was in the 1970s for publicly accusing her East German competitors of doping, King has been championed by the US media.

But prominent figures in the doping debate say the spat is also due to failures on the part of global authorities. After the World Anti-Doping Agency (WADA) this summer uncovered significant evidence of Russian state-sponsored doping and an elaborate coverup, the International Olympic Committee (IOC) came under widespread pressure from antidoping agencies to ban the entire Russian team from competing in Rio.

“They had a golden opportunity,” says Don Catlin, who spent 25 years pioneering a global antidoping model in the Olympic lab at the University of California, Los Angeles. “That’s really a deadly problem – when the IOC, of all people, who are supposed to be the face of pure sport, don’t act in the face of overwhelming evidence.”

IOC President Thomas Bach has rebuffed such criticism, arguing that “engagement and not isolation is the key to build a more robust antidoping system.” He defended the IOC’s decision not to pursue the “nuclear option” of a full ban, because of the collateral damage of innocent athletes not being allowed to compete. “The cynical ‘collateral damage approach’ is not what the Olympic movement stands for,” he said.

A personal plea

When Efimova came out to compete in the final, the crowd booed. That marked an unusually dissonant note for the Olympics, which despite its scandals and modern commercialism has managed to remain a refuge for championing the human spirit irrespective of nationality.

In the post-race press conference, Efimova, at times appearing on the verge of tears, pleaded for understanding of her individual case.

She was originally suspended in 2014 for testing positive the year before for a banned anabolic steroid, DHEA, which she said she ingested unknowingly – blaming her bad English and a clerk at a California store where she bought a supplement that included DHEA. FINA, the international swimming federation, reduced her suspension to 16 months.

Then this year she was suspended again, this time for meldonium, a popular drug among Russians and East Europeans that WADA added to its list of banned substances in January. Normally, a second doping offense is grounds for a lifetime ban. But WADA appears not to have fully understood how long it would take the drug to get flushed out of an athlete’s system, and thus athletes who stopped using it before the ban took effect were still testing positive for it. On WADA's recommendation, FINA lifted Efimova's suspension in May.

“I think WADA has backed off on most all of the meldonium positives – which is a good thing, they never should have done it in the first place,” says Dr. Catlin. “It’s just causing a lot of legal headaches.”

Winter Olympics affected

Efimova’s problems grew, however, when WADA uncovered what they described as a massive system of state-sponsored doping and coverups in Russia, put in place after the country's humiliating performance at the 2010 Olympics. According to a WADA-commissioned a report released in July, all positive drug tests of Russian athletes were sent to the minister of sport and he personally decided whose violations to cover up and whose to expose, allowing some dirty athletes to continue competing.

The report also described an elaborate system of covering up positive drug tests at the 2014 Sochi Olympics, where Russian athletes won 33 medals, the most of any country.

For the Rio games, the IOC came under widespread pressure to impose a blanket ban on Russia, but declined, instead leaving it up to international sports federations to decide whether each athlete met certain criteria.

Efimova, who has been training in California for the past few years, took her case to the Court of Arbitration for Sport and was cleared to compete at the last minute.

“If you know the circumstances of Yulia’s first positive, and you know the circumstances of meldonium, then it’s really hard to justify the outrage,” says Howard Jacobs, a California attorney who defended Efimova after her first suspension. “Unless you believe that she was part of some state-sponsored Russian doping scheme. But if she is, where’s the evidence of it?”

Indeed, it is unclear to what extent Efimova may have been involved in Russia’s state-sponsored doping program while in the US. The US Anti-Doping Agency confirmed to the Monitor that though she is a foreign athlete, she has been subject to the USADA testing regime. Still, meldonium is not legally available in the US, raising questions about where she got it.

While any doping represents a violation of sports ethics, the severity of violations varies widely, from ingesting a banned substance via a nutritional supplement to blood doping. Mr. Jacobs, who has made a name for himself defending athletes accused of doping, says the global antidoping movement is making progress on implementing longer sanctions for the more serious violations.

“I’m not as convinced that you’re getting shorter sanctions for athletes … in situations where they inadvertently used banned substances,” he says.

The complex issues surrounding Efimova’s case have been somewhat clouded by the politics of sport. Russians have also blamed global politics for what they see as a double standard in antidoping enforcement.

“When it becomes a matter of politics, nobody cares very much about the truth. And that’s not good,” says Jan Paulsson, a lawyer and veteran CAS arbitrator now at the University of Miami School of Law. “It’s like political arm-wrestling, and principle gets forgotten.”